Complementary Interventions for Preventing and Controlling Iodine Deficiencies in Pregnant Women, Infants, and Young Children
Arnold Timmer *
UNICEF, New York City, USA.
Carmen Ho
University of Toronto, Toronto, Canada.
Michael Zimmerman
ETH Zürich, Zürich, Switzerland.
Jonathan Gorstein
University of Washington, Seattle, USA.
Frits Van der Haar
Emory University, Atlanta, USA.
*Author to whom correspondence should be addressed.
Abstract
Objectives: Inadequate dietary iodine is the main cause of preventable brain damage, posing a serious threat to intellectual development and productivity throughout the world. Salt iodization is the primary strategy for preventing and eliminating iodine deficiencies, and 76% of households worldwide have access to adequately iodized salt. In several settings, new interventions provide iodine containing products for vulnerable groups - pregnant and lactating women, infants (0-5 months), and young children (6-23 months). However, the extent to which these ‘complementary interventions' meet the iodine requirements of these groups has not been investigated. We therefore examined these interventions to understand whether they meet vulnerable groups' needs. We also estimated the number of recipients reached.
Methods: We reviewed literature, household surveys, and guidelines to assess whether salt iodization can meet vulnerable groups' iodine requirements. Then, complementary interventions used in public health contexts were mapped, their iodine contribution estimated, and the number of recipients reached calculated.
Results: Our analysis suggests that salt iodization may meet the requirements of pregnant and lactating women, but possibly not all infants and young children. There is great variability in objectives, delivery methods, and iodine contribution of complementary interventions. The coverage of various complementary interventions ranges from 0 to 13% of the vulnerable population groups.
Conclusions: There is a need for careful coordination to ensure appropriate amounts of iodine are delivered to recipients. Failing to do so can result in the delivery of too little or too much iodine, which can have negative health consequences.